Antenatal care and screening Flashcards
Where is pre-pregnancy counselling vital?
for women with any previous health or pregnancy problems
What are some of the main causes for women’s deaths in most common order (6)
heart disease blood clots epilepsy and stroke other physical conditions sepsis MH conditions
What is a red flag for pregnancy ?
severe chest pain - heart disease can occur for the first time
What lifestyle factors increase the chance of heart disease?
older, obese, smoke, diabetes, family history
When is breathlessness not normal in pregnancy?
when lying flat and resting
Women with risk factors for pre-eclampsia need what described?
aspirin from 12 weeks of pregnancy
What general health measures can be advised in pre-pregnancy counselling? (3)
Improve diet
Optimise BMI
Reduce alcohol consumption
pre-pregnancy counselling advice in primary care may include? (3) - give the drug dose if appropriate
Smoking cessation advice
Folic acid -400 mcg
5mg
Up to date cervical smear
Effects of obesity on pregnancy?
miscarriage and still birth
affects the function of the uterus in labour
Being obese in pregnancy may affect the ability to?
measure fundal height to monitor fetal growth and presentation may be impossible on abdominal palpation.
What is common in obese pregnancies?
Venous thromboembolic events
What is alcohol associated with in pregnancy?
fetal abnormalities causing a fetal alcohol syndrome
what are feature of fetal alcohol syndrome?
typical facial appearance and affects learning
Risk assessment for age of an individual - what are the differences at both end of the scale?
Teenagers may be socially deprived with lack of support, smoke more, and not receive the antenatal care they need, often booking late.
Older women, particularly the over 40s, are more prone to pre-existing medical conditions and develop complications of pregnancy such as gestational diabetes and hypertension. Chromosomal disorders increase dramatically with advancing maternal age.
What are some of the risk in pregnancies in older women (3)
gestational diabetes and hypertension
Chromosomal disorders increase
What is parity
the number of times that she has given birth to a fetus with a gestational age over 24 weeks- regardless if the child was stillborn or alive
What does nulliparity mean?
first pregnancy
What condition is common in nulliparity?
Pre-eclampsia
What predisposes women to postpartum haemorrhage?
Grand multiparity (4 or more deliveries)
How can occupation affect fetal risk? (2)
very busy job with inadequate rest periods or be exposed to substances such as chemicals
Substance misuse- what is addictive to the fetus? (3)
- what happens at birth?
Heroin, methadone and benziodiazapines
- withdrawal syndrome in the baby when it is cut off from its supply at birth
What are cocaine and crack associated with?
abruption resulting in fetal death.
Who are women with substance misuse seen by?
specialist multidisciplinary clinic involving obstetricians, midwives, members of the substance misuse team (psychiatrists & CPNs), social workers and health visitors.
Antenatal care for mother/ problems to look for
raised BP, urinalysis, mental health, birth planning
- domestic violence- support
Antenatal care for fetus/ problems to look for
screening, reduced fetal movements, malpresentation
What 4 things do you assess in antenatal examination?
- Abdominal Palpation
- Assess symphyseal fundal
height (SFH) - Estimate size of baby
- Estimate liquor volume
Some abnormal lies for a baby are secondary to?
placenta praevia which can have serious consequences around he time of delivery and are important to detect
What is placenta praevia ?
When a babies placenta partially or totally covers the mothers cervix
When would you offer ECV?
If the baby remains in a breech presentation after 36 weeks
Screening allows for?
conditions to be detected early in a symptomless population to be treated for mother/baby